Delayed presentation of right and left ventricle perforation due to suicidal nail gun injury

Area of Science:

• Cardiology
• Trauma Surgery
• Emergency Medicine

Background:

• Delayed presentation of penetrating cardiac trauma can obscure injury severity.
• Nail gun injuries pose unique diagnostic challenges due to minimal external signs.
• Cardiac tamponade is a critical complication requiring immediate recognition.

Observation:

• A case of attempted suicide involving a nail gun resulted in a nearly invisible entry point.
• The nail penetrated both the right and left ventricles, causing severe cardiac damage.
• The patient experienced cardiac arrest following general anesthesia induction.

Findings:

• Prompt history, chest X-ray, and transthoracic echocardiography were crucial for nail localization and damage assessment.
• Successful management was achieved despite the critical nature of the cardiac injury.
• The case highlights the importance of considering severe internal injuries with seemingly minor external trauma.

Implications:

• This case underscores the need for thorough investigation in cases of suspected penetrating cardiac injury, regardless of entry wound appearance.
• Effective diagnostic modalities like echocardiography are vital for managing cardiac tamponade.
• Successful outcomes are possible even after cardiac arrest with timely and appropriate interventions.